Hand Washing and Use of Gloves While Managing Patients Receiving Mechanical Ventilation in the ICU*

*From the Department of Anesthesiology (Dr. Khatib and Nurses Abdallah and Ibrahim), Division of Inhalation Therapy, and the Department of Medicine (Dr. Jamaleddine), School of Medicine, American University of Beirut, Beirut, Lebanon.

Abstract

Study objective: To evaluate the effectiveness of
warning labels permanently attached to mechanical ventilators in
improving the practice of hand washing and use of gloves by respiratory
care practitioners (RCPs) in the ICU.

Design: The
study consisted of two 4-week periods. Daily observations of hand
washing and use of gloves by RCPs were made over four 1-h observation
periods. Prior to the first 4-week period, the importance of hand
washing and use of gloves was presented to all staff. At the end of the
first period, “Wash Hands Use Gloves” labels were
permanently placed on all ventilators in the ICU. The RCPs were not
aware they were being observed for hand washing and use of gloves in
either period.

Measurements and results: The total
number of encounters between the RCPs and patients as well as the rates
of hand washing and use of gloves were obtained during the study. The
rates of hand washing and use of gloves were significantly higher
during the second period when labels were attached to the ventilators,
as compared to the rates during the first period: hand washing, 92% vs
46% (p < 0.05); use of gloves, 92% vs 43% (p < 0.05),
respectively. During the first period, the rates of
pre-encounter hand washing (78%, 48%, 27%, and 29% in weeks 1
through 4, respectively) and the use of gloves (56%, 37%, 32%, and
45% in weeks 1 through 4, respectively) were primarily declining. This
was not observed during the second period of the study (94%, 88%,
95%, and 92% in weeks 1 through 4, respectively) for the rates of
pre-encounter hand washing and the use of gloves.

Conclusions: Simple measures such as the placement of
warning labels on mechanical ventilators can significantly improve hand
washing and use of gloves by RCPs in the
ICU.

Return to: Hand Washing and Use of Gloves While Managing Patients Receiving Mechanical Ventilation in the ICU*

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